Auna SA (AUNA) 2024 Q4 法說會逐字稿

Good morning and welcome to Auna's fourth quarter 2024 earnings conference call. My name is Rob and I will be your operator for today's call. At this time, all participants in a listen-only mode, and please note that this call is being recorded. (Operator Instructions) Now I would like to turn the call over to Anna Maria Mora, head of investor relations. Ma'am, please go ahead.

早上好，歡迎參加 Auna 2024 年第四季財報電話會議。我叫羅布，今天我將擔任您的電話接線生。此時，所有參與者都處於只聽模式，請注意本次通話正在錄音。（操作員指示）現在我想將電話轉給投資者關係主管安娜·瑪麗亞·莫拉 (Anna Maria Mora)。女士，請繼續。

Thank you, operator. Hello, everyone and welcome to Auna conference call to review our fourth quarter and full year 2024 results. Please note that there is a webcast presentation to accompany the discussion during this call. If you need a copy of the presentation, please go to our investor relations website or contact Auna's investor relations team.

謝謝您，接線生。大家好，歡迎參加 Auna 電話會議，回顧我們 2024 年第四季和全年的業績。請注意，本次通話期間將有一個網路廣播演示來配合討論。如果您需要簡報的副本，請造訪我們的投資者關係網站或聯絡 Auna 的投資者關係團隊。

Please note that when we discuss variances, we will be doing so on a year-over-year basis and in FX neutral or local currency terms, with regards to Mexico and Colombia, unless we know otherwise. Let's move to slide 2. In addition to reporting and audited financial results in accordance with international financial reporting standards, we will discuss certain non-IFRS financial measures and operating metrics, including foreign exchange neutral calculations.

請注意，當我們討論差異時，我們將以同比為基礎，並以外匯中性或當地貨幣計算，針對墨西哥和哥倫比亞，除非我們另有說明。讓我們轉到投影片 2。除了根據國際財務報告準則報告和審計財務結果外，我們還將討論某些非國際財務報告準則的財務指標和營運指標，包括外匯中性計算。

Investors should carefully read the definitions of these measures and metrics included in our earnings press release of yesterday to ensure that they understand them. Non-IFRS financial measures and operating metrics should not be considered in isolation as substitutes for or superior to IFRS financial measures and not provided as supplemental information only.

投資者應仔細閱讀我們昨天的收益新聞稿中包含的這些措施和指標的定義，以確保他們理解這些措施和指標。非國際財務報告準則 (Non-IFRS) 財務指標和營運指標不應孤立地視為國際財務報告準則 (IFRS) 財務指標的替代或優於國際財務報告準則 (IFRS) 財務指標，也不應僅作為補充資訊提供。

Before we begin our remarks, please also note that certain statements made during the course of today's discussion may constitute forward-looking statements which are based on management, current expectations and beliefs. And which are subject to a number of risks and uncertainties that could cause actual results to materially differ, including factors that may be beyond the company's control.

在我們開始發言之前，也請注意，今天討論過程中所作的某些陳述可能構成基於管理、當前期望和信念的前瞻性陳述。並且受到許多風險和不確定因素的影響，這些風險和不確定因素可能導致實際結果出現重大差異，其中包括公司無法控制的因素。

This includes but are not limited to or expected adjusted EBITDA growth. The expected impact on revenues and profitability of certain initiatives, we are pursuing in Mexico a long-term financial position and flexibility as a result of certain initiatives, we are pursuing related to players in Colombia and our target leverage level.

這包括但不限於或預期調整後的 EBITDA 成長。某些舉措對收入和盈利能力的預期影響，我們正在墨西哥追求某些舉措帶來的長期財務狀況和靈活性，我們正在追求與哥倫比亞的參與者和我們的目標槓桿水平相關的舉措。

For a description of these risks, please refer to our Form F-1 and or Form-20 filing with the US Securities and Exchange Commission and our earnings press release. Slide 3 please. On today's call, we have Jesus Zamora, our Executive Chairman and President, Gisele Remy, our Chief Financial Officer and Executive Vice President, and Lorenzo Massart, our Executive Vice President of strategy and Equity Capital Markets.

有關這些風險的描述，請參閱我們向美國證券交易委員會提交的 F-1 表格和/或 20 表格以及我們的收益新聞稿。請看投影片 3。參加今天電話會議的有我們的執行主席兼總裁 Jesus Zamora、我們的財務長兼執行副總裁 Gisele Remy 以及我們的策略和股權資本市場執行副總裁 Lorenzo Massart。

They will discuss Auna's consolidated and segment financial and operating results for the fourth quarter and full year, and we will also provide updates on various strategic growth initiatives. After that, we will open the call for your questions. Jesus, please go ahead.

他們將討論 Auna 第四季和全年的合併和分部財務和營運業績，我們還將提供各種策略成長計劃的最新資訊。之後，我們將開始回答大家的提問。耶穌，請繼續。

Thank you, Anna, and thank you everyone for joining our results call. We are pleased to have achieved all of the 2024 milestones at Auna, including our patient experience, medical resolution and our 20% FX neutral EBITDA growth target for 2024. We expected the second half of the year to outperform the first part, given the seasonality effect on surgical volumes. Principally, we remain excited about illness future as we maintain our growth momentum going into 2025.

謝謝你，安娜，也謝謝大家參加我們的結果電話會議。我們很高興 Auna 實現了 2024 年的所有里程碑，包括我們的病患體驗、醫療解決方案以及 2024 年 20% 外匯中性 EBITDA 成長目標。考慮到季節性對手術量的影響，我們預計下半年的表現將優於上半年。原則上，我們對疾病的未來仍然感到興奮，因為我們將在 2025 年保持成長勢頭。

Auna's vertically and horizontally integrated regional platform delivered 28% of FX neutral adjusted growth in the fourth quarter, with the margin expanding 3.1% points versus last year's quarter and 1.4% points for the year. This is as expected for the last quarter of the year. In Peru, our fully integrated healthcare and plans business remains strong as we reap the returns on earlier investments we made to build, integrate, and scale our business.

Auna 的垂直和水平整合區域平台在第四季度實現了 28% 的外匯中性調整後增長，利潤率較去年同期擴大 3.1 個百分點，全年擴大 1.4 個百分點。這與今年最後一個季度的預期一致。在秘魯，我們全面整合的醫療保健和計劃業務仍然強勁，因為我們獲得了早期為建立、整合和擴大業務而進行的投資的回報。

Peru continues to demonstrate the consistent earning powers of Auna's business model when it is operating at scale. With that in mind, we continue the deployment of our model in Mexico, where the business opportunity and potential is even greater, given the size of the country's private healthcare market and how under penetrated it is.

秘魯持續展示 Auna 商業模式在規模運作時持續的獲利能力。考慮到這一點，我們繼續在墨西哥部署我們的模式，考慮到該國私人醫療保健市場的規模及其滲透程度，那裡的商業機會和潛力更大。

As we further implement the Auna way across our hospital network in Monterrey, we've been driving operating efficiency and profitability, driving growth from new service offerings and our focus on higher complexity offerings. We're also learning what works well in Mexico and not so well as we always continue to refine our business model across our markets.

隨著我們在蒙特雷的醫院網路中進一步實施 Auna 方式，我們一直在提高營運效率和獲利能力，推動新服務產品的成長，並專注於更高複雜性的產品。我們也不斷學習在墨西哥哪些做法行之有效，哪些做法不太有效，因為我們始終在各個市場不斷完善我們的商業模式。

In Mexico, we were pleased to announce an agreement with the physicians of the most prestigious oncology practice in Monterrey. On March 7, we have signed a five-year exclusivity period with eight of Monterrey's leading oncologists and radiation oncologists who will bring their practice to own. This will position us as the oncology player of reference in Monterrey with a sizable practice and stellar results.

在墨西哥，我們很高興宣布與蒙特雷最負盛名的腫瘤診所的醫生達成協議。3 月 7 日，我們與蒙特雷八位頂尖腫瘤學家和放射腫瘤學家簽署了一份為期五年的獨家協議，他們將把他們的實踐帶到我們這裡。這將使我們成為蒙特雷具有豐富實務經驗和出色成果的腫瘤學標竿企業。

Near-term challenges remain in Colombia, with additional provisions this quarter. Accordingly, we are limiting our risk exposure in the country by calibrating growth and focusing on preserving cash. As we announced yesterday in our earnings report, we are lowering our exposure to [NSA] and replacing those volumes with other payers under risk sharing models to prioritize cash generation.

哥倫比亞近期仍面臨挑戰，本季將面臨額外挑戰。因此，我們透過調整成長和注重保留現金來限制我們在該國的風險敞口。正如我們昨天在收益報告中宣布的那樣，我們正在降低對 [NSA] 的投資，並在風險分擔模式下用其他付款人取代這些交易量，以優先考慮現金產生。

That said, we are still bullish on Colombia, given its medium- and long-term growth potential. It also remains integral to our maintaining scale and achieving medical excellence across our platform. We believe that 2025 will continue to be a challenging year in Colombia but expect 2026 to have an important increase in volume and complexity mix.

儘管如此，考慮到哥倫比亞的中長期成長潛力，我們仍然看好哥倫比亞。它也是我們在整個平台上維持規模和實現卓越醫療的關鍵所在。我們相信，2025 年對哥倫比亞來說仍將是充滿挑戰的一年，但預計 2026 年其產量和複雜性將顯著增加。

Turning briefly to our balance sheet, our debt leverage fell again to 3.6 times at year end. That's almost a full turn below our leverage last year. Q4 was also the fourth consecutive quarter of positive adjusted net income. And for the year we reported a net income of PEN124 million. That is a PEN338 million gained from the net loss of PEN214 million in 2023.

簡單回顧一下我們的資產負債表，我們的債務槓桿率在年底再次下降至 3.6 倍。這幾乎比我們去年的槓桿率低了整整一倍。第四季也是調整後淨收入連續第四個季度為正。我們報告的年度淨收入為 1.24 億秘魯索爾。這是從 2023 年淨虧損 2.14 億秘魯索爾增加 3.38 億秘魯索爾。

So, now on slide 5, revenues grew 11% on an FX neutral basis across our regional platform to about PEN1.1 billion led by Peru and Mexico. That brought full year revenue to almost PEN4.4 billion, which was 12% higher than 2023, also on an FX neutral basis. Among our healthcare facilities, capacity utilization increased 2.6% points to 66%. But our focus remains on growing high complexity services that carry higher margins rather than merely increasing capacity utilization.

因此，現在在第 5 張投影片上，我們區域平台的收入在外匯中性基礎上成長了 11%，達到約 11 億秘魯索爾，其中秘魯和墨西哥占主導地位。這使得全年收入達到近 44 億秘魯索爾，以外匯中立計算，比 2023 年高出 12%。在我們的醫療保健設施中，產能利用率提高了 2.6 個百分點，達到 66%。但我們的重點仍是發展具有更高利潤率的高複雜性服務，而不僅僅是提高產能利用率。

That focus is what drove our growth in Mexico once again this quarter. At OncoSalud, our health plans business in Peru, plan memberships continued growing. For the year, planned memberships increased 7.4%, while oncology memberships increased 1.6%. Lastly, on this slide, our oncology MLR decreases 0.7 percentage points to 53%, a very healthy level, very much in line with our expectations.

這一重點再次推動了我們本季在墨西哥的成長。在我們秘魯的健康計劃業務 OncoSalud，計劃會員數量持續增長。全年計畫會員數量增加了 7.4%，而腫瘤學會員數量增加了 1.6%。最後，在這張投影片上，我們的腫瘤 MLR 下降了 0.7 個百分點至 53%，這是一個非常健康的水平，非常符合我們的預期。

Let's move to slide 7 to take a closer look at the Mexican component of our regional platform. The implementation of the Auna way continues to bloom in Mexico, where the addressable market for us is a high multiple peruse. In Mexico, we maintain our growth momentum with revenues growing 9% versus last year's quarter while adjusted EBITDA increased 30%, also in local currency terms, driving both with higher volume and improved ticket mix in hospitalizations and ICU therapies.

讓我們翻到第 7 張幻燈片來仔細看看我們區域平台的墨西哥部分。Auna 方式的實施在墨西哥繼續蓬勃發展，在那裡我們的潛在市場是高倍數的。在墨西哥，我們保持了成長勢頭，收入較去年同期增長 9%，調整後的 EBITDA 也以當地貨幣計算增長了 30%，這得益於住院和 ICU 治療量的增長和票務組合的改善。

Also driving revenue with strategic pricing across payer tiers in our network. The sequential declines that you see in the revenue and EBITDA charts mainly reflect the seasonality we typically see at the end of each calendar year. The continued investment in the implementation of the Auna in our Mexico operations has paid off with adjusted EBITDA, increasing 30% in local currency, and a marginal expansion of 5.7% points.

我們也透過網路中各付款人層級的策略定價來推動收入成長。您在收入和 EBITDA 圖表中看到的連續下降主要反映了我們通常在每個日曆年末看到的季節性。我們在墨西哥業務中對 Auna 實施的持續投資已獲得回報，調整後的 EBITDA 以當地貨幣計算增長了 30%，小幅擴張了 5.7%。

Our model continues driving physician engagement and productivity higher while raising operating standards, enhancing medical protocols, and improving skills at our healthcare facilities.

我們的模式不斷提高醫生的參與度和生產力，同時提高營運標準、加強醫療協議並改善醫療機構的技能。

Onco Mexico entered a new phase in 2025, after a successful pilot phase, we have started developing the B2B and the B2B2C segments to gain scale in 2025. In addition, to be able to give access to policyholders outside of Monterrey, we're developing arrangements with a network of service providers in the major cities in Mexico that will serve our policy holders outside of Monterrey while we develop our physical footprint in those cities.

Onco Mexico 於 2025 年進入新階段，在試點階段成功之後，我們已開始開發 B2B 和 B2B2C 領域，以在 2025 年實現規模化。此外，為了讓蒙特雷以外的保單持有人也能享受服務，我們正在與墨西哥主要城市的服務提供者網路達成協議，這些服務提供者將在我們擴大在蒙特雷以外地區的保單持有人服務的同時，為這些城市的保單持有人提供服務。

In parallel, as I mentioned earlier, we signed a five-year exclusivity agreement with Monterrey's top oncologists and radiation oncologists who serve today about 30% of the private market in Monterrey. Eight leading physicians will join us and together we will continue positioning Auna, Mexico as the best alternative in oncology and the high complexity player of choice.

同時，正如我之前提到的，我們與蒙特雷頂尖的腫瘤學家和放射腫瘤學家簽署了一份為期五年的獨家協議，他們目前服務於蒙特雷約 30% 的私人市場。八位頂尖醫生將加入我們，我們將共同努力，繼續將墨西哥奧納定位為腫瘤學領域的最佳替代方案和高複雜性的首選參與者。

Let's turn to slide 8 on Peru. The fourth quarter revenue of our most mature fully integrated platform in Peru increased 10% as it continued capturing more of the payer population, optimizing pricing, and growing plan members. These dynamics, along with the network synergies and efficiencies that we have been achieving, drove a 33% increase in adjusted EBITDA, which increased 51% for the year.

讓我們翻到第 8 張關於秘魯的幻燈片。我們在秘魯最成熟的全整合平台第四季的營收成長了 10%，因為它繼續吸引更多的付款人群體、優化定價並增加計畫成員。這些動態，加上我們實現的網路綜效和效率，推動調整後 EBITDA 成長 33%，全年成長 51%。

Also compared to 2023, Peru's margin expanded 3.8 percentage points in the quarter and 5.4 percentage points for all of 2024. These marginal improvements were despite increases in cost of goods sold and SG&A, the latter increasing in support of growth.

與 2023 年相比，秘魯的利潤率在本季擴大了 3.8 個百分點，2024 年全年擴大了 5.4 個百分點。儘管銷售成本和銷售、一般及行政費用有所增加，但仍取得了這些邊際改善，其中銷售、一般及行政費用的增加是為了支持增長。

Now let's move to Columbia on slide 9. Our fourth quarter revenue in Colombia increased 14% in local currency, mostly because we have been gradually implementing risk sharing models in Antioquia, an area that includes Medellin. Examples of these are cardiology and chemotherapy for breast cancer. Also increasing revenue was the addition of 14 ICU beds in Barranquilla.

現在讓我們轉到幻燈片 9 上的哥倫比亞。我們第四季在哥倫比亞的營收以當地貨幣計算成長了 14%，這主要是因為我們在包括麥德林在內的安蒂奧基亞地區逐步實施風險分擔模式。例如心臟病學和乳癌化療。巴蘭基亞新增 14 張 ICU 病床也增加了收入。

Together, these additional high complexity services improved Colombia's revenue mix with larger tickets. Adjusted EBITDA increased 23% in local currency, primarily due to price adjustments from previous quarters agreed upon in the fourth quarter and procurement rebates as well as adjustments to the technical note in the risk sharing contract/

綜合起來，這些額外的高複雜性服務透過更大的票價改善了哥倫比亞的收入組合。調整後息稅折舊攤銷前利潤（EBITDA）以當地貨幣計算增長了23%，主要由於第四季度商定的與前幾季度相比的價格調整、採購回扣以及風險分擔合約中技術說明的調整。

These items, many of which typically fall in the fourth quarter of the year, also accounted for the large increase in EBITDA. Conversely, EBITDA was negatively impacted by additional provisions for impairment losses related to outstanding receivables with payers, especially [nueva epe] .The situation with the intervened payers in Colombia has deteriorated since our last earnings call, but we remain cautiously optimistic that a resolution is forthcoming.

這些項目（其中許多通常發生在第四季度）也導致了 EBITDA 的大幅成長。相反，EBITDA 受到與付款人未償應收款相關的額外減損損失撥備的負面影響，尤其是[nueva epe] 自從我們上次召開收益電話會議以來，哥倫比亞受干預付款人的情況已經惡化，但我們仍然謹慎樂觀地認為解決方案即將出台。

The current state of health care in Colombia cannot be ignored by the government nor any political party in Colombia, as frustration within the population is high, and it relates to a universal healthcare system that offers high quality of services, mostly from private companies like AUA. The government interventions have impacted all healthcare providers in the country, not just the owner.

哥倫比亞政府和任何政黨都不能忽視哥倫比亞當前的醫療保健狀況，因為民眾的不滿情緒很高，而且這與提供高品質服務的全民健保系統有關，這些服務主要來自 AUA 等私人公司。政府的干預措施影響了該國所有的醫療保健提供者，而不僅僅是所有者。

Although we believe that Auna, given its high complexity focus, is in a stronger position than most, we expect a sector solution in 2025. Until then, we remain cautious and continue to monitor our exposure closely with the discipline focused on maintaining a positive and predictable cash cycle. Our cautious stance in Colombia has not curtailed our attempts to continue to grow in volume arrangements that require upfront payment for services, and these initiatives may deliver some upside during the latter part of the year.

儘管我們認為，鑑於 Auna 的高度複雜性，其地位比大多數系統都要強，但我們預計 2025 年將會有一個行業解決方案。在此之前，我們仍將保持謹慎，並繼續密切監控我們的風險敞口，重點是保持積極且可預測的現金週期。我們在哥倫比亞的謹慎立場並沒有阻止我們繼續增加需要預付服務費用的批量安排的嘗試，這些舉措可能會在今年下半年帶來一些好處。

For now, I repeat, we remain cautious, and this stance is reflected in lower total and operating capacity in Colombia during the quarter. Emphasizing cash flow overgrowth in Q1, we began phasing out services that we deliver for [Nuepesa] in Antioquia.

就目前而言，我重申，我們仍然保持謹慎，這一立場反映在本季度哥倫比亞的總產能和營運產能下降。由於強調第一季的現金流過度成長，我們開始逐步停止為安蒂奧基亞的 [Nuepesa] 提供的服務。

We are also diversifying and reprioritizing our basic payers by reallocating services volumes to other payers. Overall, though, our underlying business remains strong in Colombia, as our most recent quality results there make clear. With that, I'll turn the call over to Gisele who will provide a more detailed review of our quarterly and full year results.

我們也透過將服務量重新分配給其他付款人來實現基本付款人的多樣化和重新排序。總體而言，我們在哥倫比亞的基礎業務依然強勁，這一點我們最近在哥倫比亞的品質成果已經明確表明了這一點。說完這些，我將把電話轉給吉賽爾，她將對我們的季度和全年業績進行更詳細的回顧。

Franc Jesus, I will now begin my review with the breakdown of revenue on [Fly 11]. In local currency terms, fourth quarter revenue increased 9% in Mexico, 10% in Peru, and 14% in Colombia. An improved services mix along with strategic pricing across payer tiers drove Mexico's sales in the fourth quarter.

Franc Jesus，我現在將開始審查收入明細[飛行 11]。以當地貨幣計算，墨西哥第四季營收成長 9%，秘魯成長 10%，哥倫比亞成長 14%。改進的服務組合以及跨付款人層級的策略定價推動了墨西哥第四季的銷售。

In Peru, healthcare services, we continue to optimize the flow of hospital services and better allocate capacity towards high complexity services, while Oncosalud expanded group memberships. Finally, in Colombia, revenues were mostly driven by the implementation of risk sharing models in high complexity services.

在秘魯的醫療服務領域，我們繼續優化醫院服務流程，更好地分配高複雜度服務的能力，同時 Oncosalud 擴大了集團成員規模。最後，在哥倫比亞，收入主要來自於高複雜度服務中風險分擔模式的實施。

Let's move to Evea on slide 12. On this slide, we break down the 28% FX neutral growth in adjusted EBITDA between fourth quarter 2023 and fourth quarter 2024. This, as well as the 23% EBITDA increase reported in the third quarter, are the back-ended growth that we had previously communicated, which led to us meeting our 2024 annual guidance as Jesus previously mentioned.

讓我們轉到第 12 張投影片上的 Evea。在這張投影片中，我們細分了 2023 年第四季至 2024 年第四季調整後 EBITDA 的 28% 外匯中性成長。這一成長以及第三季報告的 23% EBITDA 成長都是我們先前傳達的後端成長，這使我們能夠實現 Jesus 之前提到的 2024 年年度指引。

Above the bridge are the corresponding margins for each of the segments. As you can see, each of our segments delivered strong levels of profitable growth and also maintained excellent margins through operational synergies and improving efficiencies. On a consolidated basis, adjusted EBITDA margins expanded to 3 percentage points to nearly 24%.

橋的上方是每個部分的相應邊緣。如您所見，我們的每個部門都實現了強勁的獲利成長，並透過營運協同效應和提高效率保持了優異的利潤率。綜合來看，調整後的 EBITDA 利潤率擴大 3 個百分點，達到近 24%。

In Peru, our most mature segment, EBITDA increased 33% year-over-year, while its margin expanded 3.8 percentage points. In Mexico, we continue diligently implementing the own way, achieving an improved mix of services across its hospital network and tickets that reflect our focus on high complexity. As a result, EBITDA increased 30% while margin expanded 5.7 percentage points to 34.7%.

在我們最成熟的市場秘魯，EBITDA 年成長 33%，利潤率擴大 3.8 個百分點。在墨西哥，我們繼續努力實施自己的方式，實現了整個醫院網路和票據服務組合的改善，反映了我們對高複雜性的關注。結果，EBITDA 成長了 30%，利潤率提高了 5.7 個百分點，達到 34.7%。

In Colombia, EBITDA growth was impacted by certain price increases and procurement rebates that reflect full year performance but were agreed in the fourth quarter. The quarter's consolidated EBITDA growth was partially offset by the provisions and risk mitigation measures that we implemented in Colombia, and also by the investments that we have been making to build out our local and regional capabilities in Mexico.

在哥倫比亞，EBITDA 成長受到某些價格上漲和採購回扣的影響，這些上漲和回扣反映了全年業績，但在第四季度達成了一致。本季的綜合 EBITDA 成長部分被我們在哥倫比亞實施的撥備和風險緩解措施以及我們為在墨西哥建立本地和區域能力而進行的投資所抵消。

Let's turn to slide 13, which presents an EBITDA bridge for the full year. For the year, our regional operations delivered PEN993 million of adjusted EBITDA, 20% higher than 2023 and in line with the guidance we had given. Peru and Mexico led the way with stellar EBITDA growth in the case of Peru, our most mature business, showing once again that our vertically integrated model of scale delivers incredible value.

我們翻到第 13 張幻燈片，它展示了全年的 EBITDA 橋。本年度，我們區域業務的調整後息稅折舊攤銷前利潤 (EBITDA) 為 9.93 億秘魯索爾，比 2023 年高出 20%，符合我們給出的預期。秘魯和墨西哥市場處於領先地位，秘魯（我們最成熟的業務）的 EBITDA 成長顯著，再次表明我們的垂直整​​合規模模式能夠帶來令人難以置信的價值。

Peru's adjusted EBITDA dot increased 51%, while its margin expanded 5.4 percentage points. Mexico's EBITDA increased 10% in FX neutral terms, and despite Colombia's setbacks with payer interventions and related provisions affecting the P&L, the segment managed to grow EBITDA, which increased 6% for the year also in FXN.

秘魯調整後的 EBITDA 點值成長了 51%，利潤率則擴大了 5.4 個百分點。以外匯中性計算，墨西哥的 EBITDA 增長了 10%，儘管哥倫比亞因付款人幹預和相關條款影響了損益，但該部門的 EBITDA 仍實現了增長，按外匯中性計算，本年度 EBITDA 也增長了 6%。

Let's move on to adjusted net income on Fly 14. Adjusted net income was a positive PEN36 millions in the fourth quarter versus PEN6 million in last year's fourth quarter. It was our fourth consecutive quarter of positive adjusted net income. Behind the year-over-year improvement, operating profit increased 46% or PEN60 million, while our operating margin expanded just over 5 percentage points to nearly 18%.

讓我們繼續討論 Fly 14 的調整後淨收入。第四季調整後淨收入為正 3,600 萬秘魯索爾，而去年第四季為正 600 萬秘魯索爾。這是我們連續第四個季度實現調整後淨收入為正。在年成長的背後，營業利潤成長了 46% 或 6,000 萬秘魯索爾，而我們的營業利潤率則擴大了 5 個百分點，達到近 18%。

Keep in mind this includes a PEN9 million in impairment provisions in Colombia. The PEN73 million FX loss variants that you see in the bridge is the product of a non-cash FX loss of PEN24 million in the quarter compared to an FX gain in the comparable period last year, mainly related to the depreciation of the Peruvian soil relative to the US dollar during the quarter, outside the levels of the call spread hedges that we have in place.

請記住，這包括哥倫比亞的 900 萬秘魯索爾減損準備金。您在橋樑中看到的 7,300 萬秘魯索爾外匯損失變數是本季非現金外匯損失 2,400 萬秘魯索爾，而去年同期則為外匯收益，這主要與本季秘魯貨幣對美元的貶值有關，超出了我們實施的看漲價差對沖水準。

Moving across to net interest expenses, these fell 63% versus last year's quarter, mainly due to the fact that the fourth quarter, 2023 included PEN215 million of refinancing costs related to the 2023 refinancing exercise. Let's please move on to the next slide. Adjusted net income for the year was PEN146 million, Up from PEN14 million in 2023. Our operating profit increased 40% or PEN223 million.

至於淨利息支出，與去年同期相比下降了 63%，這主要是因為 2023 年第四季包括與 2023 年再融資活動相關的 2.15 億秘魯索爾再融資成本。請我們繼續看下一張投影片。全年調整後淨收入為 1.46 億秘魯索爾，高於 2023 年的 1,400 萬秘魯索爾。我們的營業利潤成長了 40%，即 2.23 億秘魯索爾。

This increase included the PEN44 million reversal of the holdback obligation from our 2022 acquisition of Auna in Mexico. This was partially offset by the PEN26 million of impairment losses in Colombia that we incurred during the year. The PEN118 million FX variants versus last year includes a negative non-cash impact of PEN42 million in 2024, which compares to a positive FX gain of PEN76 million in 2023, when the Peruvian soil appreciated versus the dollar.

這一增長包括我們 2022 年收購墨西哥 Auna 時產生的 4,400 萬秘魯索爾的保留義務的逆轉。這部分被我們今年在哥倫比亞發生的 2,600 萬秘魯索爾減損損失所抵消。與去年相比，1.18 億秘魯索爾的外匯變化包括 2024 年 4,200 萬秘魯索爾的負面非現金影響，而 2023 年秘魯索爾兌美元升值時，外匯收益為 7,600 萬秘魯索爾。

For the year, net interest expenses decreased 26% compared to 2023, due to last year's refinancing that I explained earlier. Income taxes in 2024 decrease pen30 million or 34% as our effective tax rate has normalized in 2024, given the recognition of deferred tax benefits, which we should be able to capture in cash flows in the following years.

由於我之前解釋過的去年的再融資，今年的淨利息支出與 2023 年相比減少了 26%。由於我們的有效稅率在 2024 年已經正常化，考慮到遞延稅項收益的確認，我們應該能夠在接下來的幾年中在現金流中獲取這些收益，因此 2024 年的所得稅將減少 3000 萬美元或 34%。

The PEN203 million variants in non-cash extraordinary items and adjustments for the year include again, mainly the refinancing effects from fourth quarter 2023. Let's now please turn to Cash on slide 16. The cash position improved for a second consecutive quarter to PEN236 million at the end of the year and represented an 18% sequential increase from the third quarter of 2024.

本年度非現金非常項目和調整的 2.03 億秘魯索爾變數再次主要包括 2023 年第四季起的再融資影響。現在請翻到第 16 張投影片上的「現金」。現金狀況連續第二季改善，截至年底達到 2.36 億秘魯索爾，較 2024 年第三季季增 18%。

Net tasks from operating activities increased 15% year-over-year, or PEN86 million to PEN668 million in 2024. Cash generated from operating activities during this period increased PEN161 million, or 24%, partially offset by an PEN80 million increase in tax payments in Mexico and Peru due to higher profits. Regarding the PEN160 million of CapEx shown in the bridge, this was mainly maintenance CapEx, which represented 3.7% of 2024 revenues.

經營活動淨任務年增 15%，即 8,600 萬比索至 2024 年 6.68 億比索。本期間經營活動產生的現金增加了 1.61 億秘魯索爾，即 24%，但由於利潤增加，墨西哥和秘魯的稅收增加了 0.8 億秘魯索爾，部分抵消了這一增加。至於橋上顯示的 1.6 億秘魯索爾資本支出，這主要是維護資本支出，佔 2024 年收入的 3.7%。

It was mostly related to infrastructure, medical equipment purchases, and the implementation of SAP throughout our regional platform. The PEN77 million of earnout and holdback obligations refer to the extraordinary earnout payment of the [Ema Ogomena] obligation and the holdback obligation for the Onca acquisition.

它主要與基礎設施、醫療設備採購以及整個區域平台的 SAP 實施有關。7,700 萬秘魯索爾的獲利和保留義務是指 [Ema Ogomena] 義務的特別獲利支付和 Onca 收購的保留義務。

In 2024, we generated PEN432 million of free cash flow. In the case of organic free cash flow, which excludes the earnout and holdback amortizations, we generated PEN509 million, which was 18% higher than 2023. It is important to note that organic free cash flow rose above interest payments in the second half of the year. Interest paid was PEN503 million, down 19% from 2023, and also includes interest and hedge premiums.

2024年，我們產生了4.32億秘魯索爾的自由現金流。就有機自由現金流（不包括盈利和保留攤銷）而言，我們產生了 5.09 億秘魯索爾，比 2023 年高出 18%。值得注意的是，下半年有機自由現金流超過了利息支付。支付的利息為 5.03 億秘魯索爾，比 2023 年下降 19%，其中還包括利息和對沖溢價。

Please move on to slide 17. We insured 2025 with a substantially improved credit profile. As the bar chart at the bottom of the slide shows, we continue steadily deleveraging our balance sheet with the leverage ratio falling for the ninth consecutive quarter to 3.6 times consistent with our commitment to deleveraging.

請移至第 17 張投影片。我們確保 2025 年的信用狀況將大幅改善。正如幻燈片底部的條形圖所示，我們繼續穩步降低資產負債表的槓桿率，槓桿率連續第九個季度下降至 3.6 倍，這與我們的去槓桿承諾一致。

Additionally, and as duly communicated, last December, we extended our one's maturity profile with the full reduction of the outstanding amount of the notes due, 2025. This was funded through a private reopening of the existing notes due, 2029. The new a amount of the outstanding 2029 notes is now $310 million.

此外，正如去年 12 月正式通報的那樣，我們延長了債券的到期期限，並全額減少了 2025 年到期的票據的未償還金額。該專案資金來自私下重新發行 2029 年到期的現有票據。2029 年未償還票據的新金額目前為 3.1 億美元。

As shown in the ring chart on the right of this slide, more than half of Auna's debt is in direct local currency funding, while the portion in US dollars is mainly hedged to the Peruvians. To conclude, our credit profile gives us the financial strength and flexibility needed to continue supporting our growth initiatives and achieve our strategic goals.

如本投影片右側的環狀圖所示，Auna 一半以上的債務都是直接以本幣融資，而以美元融資的部分則主要與秘魯人避險。總而言之，我們的信用狀況為我們提供了繼續支持我們的成長計畫和實現策略目標所需的財務實力和靈活性。

Further, through the EBITDA trajectory that we have established and through debt amortization, we continue to track to achieve our medium-term target of three times leverage ratio in the medium term. I'll now hand the call back to Jesus, who has a few remarks before we open the call for questions.

此外，透過我們已經建立的 EBITDA 軌跡和債務攤銷，我們將繼續追蹤實現中期三倍槓桿率的中期目標。現在我將把電話交還給耶穌，在我們開始提問之前，他有幾點發言。

Thank you, Gisele. We are carrying strong momentum into 2025 and remain committed to transforming and modernizing healthcare in Spanish speaking Latin America with our unique and proven operating model, as well as value-based care. In addition to increasing access to advanced healthcare and improving medical resolutions, we are driving sustainable long-term growth.

謝謝你，吉賽兒。我們將以強勁的勢頭邁向 2025 年，並​​將繼續致力於透過我們獨特且成熟的營運模式以及基於價值的護理來改變和現代化拉丁美洲西班牙語地區的醫療保健。除了增加先進醫療保健的機會和改善醫療解決方案之外，我們還在推動可持續的長期成長。

The Peruvian and Mexican segments of our regional healthcare platform are expected to be the primary drivers of Auna's growth going forward, with a focus on continually improving synergies and operating efficiencies as well as increasing access. Peru will continue our performing given the maturity and scale of this business.

我們區域醫療保健平台的秘魯和墨西哥分部預計將成為 Auna 未來成長的主要驅動力，重點是不斷提高協同效應和營運效率以及增加可及性。鑑於該業務的成熟度和規模，秘魯將繼續我們的表現。

We expect Mexico's performance to continue strengthening this year through a greater mix of high complexity services, targeted physician recruitment, and increasing physician productivity. Longer term, it will gradually become a far larger contributor as we scale in the country's much larger healthcare market and vertically integrate our operations.

我們預計，透過更加多樣化的高複雜性服務、有針對性的醫生招募以及提高醫生的工作效率，墨西哥今年的表現將繼續增強。從長遠來看，隨著我們擴大中國更大的醫療保健市場並垂直整合我們的業務，它將逐漸成為更大的貢獻者。

Colombia remains a strategically important market for us in terms of scale and best practices in medicine. In the near term, we will continue taking a conservative approach that helps ensure reliable cash flows and operational stability, that includes diversifying and reprioritizing Iona's mix of payers in the country.

從規模和醫藥最佳實踐來看，哥倫比亞對我們來說仍然是一個具有戰略重要性的市場。短期內，我們將繼續採取保守的做法，以確保可靠的現金流和營運穩定性，其中包括多樣化和重新調整 Iona 在該國的付款人組合。

This year we will also continue developing Onco Mexico into a disruptive insurance product, leveraging our many years of experience with Oncosalud and aiming to replicate the success that we've had with this product in Peru. As a reminder, the initial focus of its launch is on the B2B and B2B2C segments of Mexico's insurance market.

今年，我們也將繼續將 Onco Mexico 開發為一款顛覆性的保險產品，利用我們多年來在 Oncosalud 方面的經驗，旨在複製我們在秘魯推出產品所取得的成功。提醒一下，該產品推出的最初重點是墨西哥保險市場的 B2B 和 B2B2C 領域。

Additionally, agreements such as the one with the oncologists, physicians will further position us to expand our footprint across Mexico. Finally, Auna remains strongly positioned with a clear path to higher levels of growth and profitability. In addition to our proven business model, we have the right growth strategy to address the unique context of each market and capitalize on the many growth opportunities within them.

此外，與腫瘤學家、醫生等達成的協議將進一步幫助我們擴大在墨西哥的業務範圍。最後，Auna 仍保持著強勁的市場地位，並擁有實現更高成長和獲利水平的明確路徑。除了我們成熟的商業模式之外，我們還擁有正確的成長策略，以應對每個市場的獨特情況並利用其中的眾多成長機會。

And as always, patient centricity and value-based care will be at the heart of what we do. That concludes our prepared remarks. Operator let's open the call for questions.

像往常一樣，以患者為中心和基於價值的護理將是我們工作的核心。我們的準備好的演講到此結束。接線員，讓我們開始提問吧。

(Operator Instructions)

（操作員指示）

Mauricio Cepeda, Morgan Stanley

毛里西奧·塞佩達，摩根士丹利

Hello, Jesus. Thanks for the opportunity here. I have two questions. The first one about seasonality. If you could please explain the seasonality in health services in Mexico and Peru. So typically, what would be the distribution of volumes across quarters in the year for Mexico and Peru. So, we can understand a little bit this kind of quarterly variation effects that you that you live on.

你好，耶穌。感謝有這樣的機會。我有兩個問題。第一個關於季節性。請您解釋一下墨西哥和秘魯醫療服務的季節性。那麼，通常情況下，墨西哥和秘魯一年中各季度的產量分佈是怎麼樣的呢？因此，我們可以稍微了解這種季度變化對您所賴以生存的影響。

And the second question is about the demand in Monterrey. If you see that there is, there are enough policyholders in Monterey. If your strategy for now would be to conquer share from this pool, right? I understand that you're increasing complexity, but if you have a strategy to conquer share from the pool

第二個問題是關於蒙特雷的需求。如果您發現有，則表示蒙特雷有足夠的保單持有人。如果您現在的策略是從這個池子中奪取份額，對嗎？我知道你正在增加複雜性，但如果你有策略來贏得市場份額

or if you have any kind of strategy to partner with insurers there and try to increase the number of policies in the city, and by policies, I mean not your own policies. I'm referring to policies that can be offered by [Gurs] that somehow can bring you volumes. Thank you.

或者如果您有任何策略與那裡的保險公司合作並嘗試增加該城市的保單數量，並且我所說的保單不是指您自己的保單。我指的是 [Gurs] 可以提供的可以為您帶來銷售的政策。謝謝。

Great thank you, Mauricio. Great, set of questions and the first one, I can only comment more conceptually and maybe directionally on seasonality. What we see is of course at the end of the year, people delay the procedures, as everybody knows, at the beginning of the year, especially in the southern hemisphere, also because of the summer of the summer season.

非常感謝，毛里西奧。太好了，對於這一系列問題，第一個問題，我只能從概念和方向上對季節性進行評論。我們看到的情況是，當然在年底，人們會推遲這些程序，正如大家所知，在年初，特別是在南半球，也是因為夏季的緣故。

So, we see that -- in addition to that we see particularly in Mexico a more pronounced growth of volume in the second semester, notwithstanding that December is slow and January as well is slow. I must forewarn investors January is also slow. No, we see that because of this patients and doctors as well, deferring procedures, no.

因此，我們看到——除此之外，我們也看到墨西哥第二學期的銷售成長更加明顯，儘管 12 月和 1 月的銷售成長也比較緩慢。我必須提前警告投資者，一月份的業績同樣緩慢。不，我們看到，由於這個原因，患者和醫生也推遲了手術，不。

I'll ask Gisele when I finish the second question. Maybe she has the numbers or she wants to compliment the view on seasonality. We don't have much more than that. Maybe in the future we can do, we can share something else in earnings release, but we would need to be a little more diligent and just respond something out of the cuff.

當我回答完第二個問題時我會問吉賽兒。也許她有數字，或者她想讚美季節性的觀點。我們沒有更多了。也許在未來我們可以在收益發布中分享一些其他的東西，但我們需要更加勤奮，並且能夠即興地回應一些事情。

And the demand in Monterrey, I would say, a couple of things. We're working with insurers to expand the size of the market. We're working with insurers to take on some of the high complexity risk, and the attached volume of that. We're working with employers, also to expand, the market that has some kind of coverage, sometimes covered by employers, through insurance companies or not.

我想說的是，蒙特雷的需求有幾件事。我們正在與保險公司合作，擴大市場規模。我們正在與保險公司合作，承擔一些高複雜性風險及其附帶的風險量。我們正在與雇主合作，以擴大具有某種保險的市場，有時由雇主透過保險公司承保，有時不透過保險公司承保。

We think we will be very deliberate in conquering high complexity share, and we are I think we're very excited about not these are not, transactional relationships. We're working with important payers to partner, with an important relationships with respect to high complexity procedures, curtailing the cost for them and for us increasing the volume and the predictability of that business.

我們認為，我們將非常謹慎地征服高複雜性份額，我認為我們對這些不是交易關係感到非常興奮。我們正在與重要的付款人合作，在高複雜性程序方面建立重要的關係，為他們降低成本，並為我們增加業務量和可預測性。

So, we are excited in that we are not, I want to repeat this, we're not just another provider of healthcare services and I think I'm very convinced about it. Yesterday I was visiting an insurer, one of the leading shares in Mexico, and clearly no one sees us as another provider of healthcare services in Mexico. Our model is unique and transformative. It's not easy to digest, I must say that it's not easy.

所以，我們很高興，我想重申一下，我們不僅僅是另一家醫療服務提供者，我認為我對此非常有信心。昨天我拜訪了一家保險公司，這是墨西哥的主要股票之一，顯然沒有人將我們視為墨西哥另一個醫療服務提供者。我們的模型是獨特的、具有變革性的。這並不容易消化，我必須說這並不容易。

No, it does take a bit more time to ground and expand, in a country like Mexico. But I think we're getting great traction, the relationship with payers and insurance companies in general is very promising. Gisel, do you want a compliment on seasonality? Do you have any view on that?

不，在墨西哥這樣的國家，它確實需要更多的時間來紮根和擴張。但我認為我們正在取得巨大進展，與付款人和保險公司的關係總體上非常有前景。吉塞爾，你想聽聽關於季節性的讚美嗎？您對此有何看法？

Yeah, sure, so I would just kind of reiterate the point that we do tend to see softer volumes across the geographies in Q4 and Q1, specifically for given the holidays and the seasonal impacts of, the end of the year and the beginning of the year where, as Suso mentioned, elective types of procedures are deferred. Okay. Not only effective and not only elected because sometimes, it's just procedures that can be deferred.

是的，當然，所以我只是想重申這一點，我們確實傾向於在第四季度和第一季度看到各個地區的交易量較弱，特別是考慮到假期和年底和年初的季節性影響，正如蘇索提到的，選擇性手術被推遲。好的。這不僅有效，而且不僅是選舉出來的，因為有時，這只是可以推遲的程序。

There's some procedures in orthopedics, people don't want to have, their hip replaced in December and January. They want to have it in a month that's outside of the sea, outside of those months. So, there are some things that are not elected that can be delayed and they are delayed.

在骨科中，有些手術是人們不願意做的，例如在 12 月和 1 月進行髖關節置換術。他們希望在遠離海洋的月份，也就是那些月份以外的月份進行。所以，有些事情不是選舉出來的，可以拖延，但卻被拖延了。

That's very clear. Thank you, Suso.

這非常清楚。謝謝你，蘇索。

Samuel Alves, BTG Pactual.

塞繆爾·阿爾維斯（Samuel Alves），BTG Pactual。

Good morning, Suso, Gisele, Lorenzo. Good morning, everyone. Well, two quick questions here. The first one is about the growth by geography expected for 2025. Last year, the growth in local currencies was largely driven by Peru, right?

早安，蘇索、吉賽兒、洛倫佐。大家早安。嗯，這裡有兩個簡單的問題。第一個是關於預計 2025 年各地區的成長。去年當地貨幣的成長很大程度上是受秘魯推動的，對嗎？

So for 2025, do you think that Mexico will be the top growth market with Colombia? Maybe be remaining flat flattish and there somewhere in between. Does it make sense, this breakdown.

那麼到 2025 年，您認為墨西哥將與哥倫比亞一起成為最大的成長市場嗎？也許保持平坦或處於兩者之間的某個位置。這種細分有意義嗎？

And the second question is about liability management. Maybe if you guys could recall what the main liability management initiatives are recently done by the company and what additional alternatives the company might do this year. If you guys in his age in any potential assets to speed up the process, that's it. Thank you very much.

第二個問題是關於負債管理。也許你們可以回憶一下公司最近採取的主要責任管理舉措以及公司今年可能採取的其他替代方案。如果你們在他這個年紀有什麼潛在資產可以加速這一進程的話，那就是它了。非常感謝。

Thank you so much. The second one, the second question I didn't hear perfectly, was it about management or the leverage li?

太感謝了。第二個，第二個問題我沒有聽清楚，是關於管理還是槓桿率？

Hi what liability management, yeah.

你好，什麼是責任管理，是的。

Okay, great. You can do that one you said and so in general, Samuel, so, I have to explain this. I've tried to explain in the past so we run the company with a 20% EBITDA. Even that growth, so all our managers know that is the goal, this is not something we, it's not something for guidance for the market. This is how we run the company, but it is a product, and we run it for the for the consolidated basis, no, and we, and we also have the benefit, we believe it's a benefit. Of diversification of three countries and the insurance and the healthcare services business, and we run all those businesses to make sure that we're always hitting the 20% annually. It's very important annually. This is our target. No, this is an internal target that of course coincides with what we declared to the market.

好的，太好了。你可以做到你說的那個，所以一般來說，塞繆爾，所以，我必須解釋這一點。我過去曾嘗試解釋，所以我們以 20% 的 EBITDA 來經營公司。即使是那種成長，我們所有的經理都知道那是目標，這不是我們想要的，也不是市場指導的東西。這就是我們經營公司的方式，但它是一種產品，我們以合併為基礎來經營它，不，而且我們也有好處，我們相信這是一種好處。我們經營三個國家的多元化業務以及保險和醫療保健服務業務，以確保我們每年始終達到 20% 的成長率。每年這都非常重要。這就是我們的目標。不，這是一個內部目標，當然與我們向市場宣布的目標一致。

This 2025, more generally somewhat. Because of externalities, principally payers in Colombia, and our decision to limit our growth there, we see that as something that we're acting on, we're aggressive on, but we don't have full control. So we're saying, let's make sure that internally management has the right incentives, we have the right action plans to deliver the 20%. But we also know that, we might be hit by, some news, that is not under control. And we like to be conservative about what we say.

這個2025年，比較普遍一些。由於外部因素，主要是哥倫比亞的付款人，以及我們決定限制在那裡的增長，我們認為這是我們正在採取行動的事情，我們正在積極採取行動，但我們無法完全控制。所以我們的意思是，我們要確保內部管理有正確的激勵措施，有正確的行動計畫來實現 20% 的目標。但我們也知道，我們可能會受到一些無法控制的消息的打擊。我們喜歡保守地發表言論。

I would say that Mexico, directionally, given what we're doing and harvesting, especially again in high complexity, again with the doctors we just hired, we're going to do something very similar in orthopedics and cardiology. It takes time. It, I want to again, it's not an excuse. I mean this is what we do. The obionocoloia, transaction that we actually revealed last week, no, it took us like two years.

我想說，從方向上看，考慮到我們正在做的事情和收穫，特別是在高度複雜的情況下，以及我們剛剛聘請的醫生，我們將在骨科和心臟病學方面做一些非常類似的事情。這需要時間。這，我再說一遍，這不是藉口。我的意思是這就是我們所做的。我們上週實際披露的 obionocoloia 交易，不，我們花了兩年時間。

It's a great transaction, great for them, for the doctors, great for us, and great for patients and great for the system in Monterrey. It's a new standard of what we're doing there, but it took us three years and we're working in the other practices in the same way, and we'll deliver that in the future as well. But it takes a little bit. It takes some time.

這是一次偉大的交易，對他們、對醫生、對我們、對病人、對蒙特雷的醫療體係來說都是偉大的。這是我們在那裡所做工作的一個新標準，但我們花了三年時間，我們以同樣的方式在其他實踐中開展工作，並且我們將來也會實現這一點。但這需要一點時間。這需要一些時間。

I think Mexico will be harvesting more substantial growth, this year. No, I think Colombia, I'm uncertain if it'll be, no growth or maybe depending on what might occur in the system. The system right now has a huge demand of services.

我認為墨西哥今年將實現更顯著的成長。不，我認為哥倫比亞，我不確定它是否不會增長，或者可能取決於系統中可能發生的情況。該系統目前對服務的需求龐大。

And we're saying we're happy to take those services if you pay upfront. And we might get traction on that, so there might be a surprise, and we might see some growth out of Colombia. Peru is a stable growing business. It's a stable growing business and we manage it that way. And we think it what it proved in 2024, I think was, very high and good and as we wanted it to, but it's a product of what we do to always deliver this this 20% internally that we also represent as guidance.

我們說如果您預先付款，我們很樂意接受這些服務。我們可能會在這方面取得進展，因此可能會有一個驚喜，我們可能會看到哥倫比亞的一些增長。秘魯是一個穩定成長的企業。這是一個穩定成長的業務，我們以這種方式進行管理。我們認為，正如 2024 年所證明的那樣，這一數字非常高，非常好，正如我們所希望的那樣，但這是我們內部始終實現這一 20% 目標的結果，我們也將其作為指導。

No, again, in this year we're a little bit sensitive to calling it guidance because of the Colombia uncertainty of these externalities. Do you want a compliment and also take the other question on management liability management?

不，再說一次，今年我們對稱之為指導有點敏感，因為哥倫比亞對這些外部因素的不確定性。您想要稱讚嗎？同時還要回答其他有關管理責任管理的問題嗎？

Yeah, sure, so, with reference to the second question, some from a liability management perspective, what has been done thus far as commented in the earnings release in the fourth quarter, we refinanced the remaining stub of the 2025 bonds through a private reopening of the 2029 bonds. This was a small refinancing of, the approximately $57 million that we disclosed.

是的，當然，關於第二個問題，從負債管理的角度來看，正如第四季度收益報告中所評論的那樣，迄今為止所做的工作是，我們透過私下重新發行 2029 年債券為 2025 年債券的剩餘部分進行了再融資。這是小額再融資，我們揭露的金額約為 5700 萬美元。

And as far as a more structural liability management exercise, we have obviously been analyzing alternatives in the market. Our bond is trading quite well above par, which also gives us a view that our current cost of funding is well below what we obtained when we did the 2023 financing exercise.

至於更具結構性的負債管理措施，我們顯然一直在分析市場上的替代方案。我們的債券交易價格遠高於票面價值，這也使我們認為，我們目前的融資成本遠低於我們在 2023 年融資時獲得的融資成本。

We have also seen our credit profile improve materially, as is also demonstrated by what we saw. In the leverage and liquidity levels, so we are obviously actively evaluating refinancing alternatives which, as we know, are always booked for in local currency. So, this is something that we continue to analyze and hopefully we'll have news there in the coming quarters.

我們的信用狀況也得到了實質改善，這一點也由我們所見所聞所證明。在槓桿和流動性水平方面，我們顯然正在積極評估再融資替代方案，正如我們所知，這些方案始終以當地貨幣記帳。因此，我們會繼續分析這個問題，並希望在接下來的幾個季度內獲得相關消息。

Thank you. Suso.

謝謝。蘇索。

Leandro Bastos, Citi

花旗銀行 Leandro Bastos

Hello guys. Thanks for taking the caution. We actually have first one on [oncosalud]. If you could discuss a little bit commercial strategy and the outlook for 2025. I mean we saw last year very strong commercial growth, but not as much in terms of ticket progression. I don't know if have kind of a mixed component here or kind of if you could discuss a little bit the strategy for price increases on the health plans.

大家好。感謝您的謹慎。我們實際上有第一個[腫瘤健康]。您能否討論一下商業策略和 2025 年的展望？我的意思是，去年我們看到了非常強勁的商業成長，但票房成長卻沒有那麼強勁。我不知道這裡是否有混合成分，或者您是否可以討論健康計劃價格上漲的策略。

So that would be the first one. And second, just kind of an update on Colombia you mentioned during the call kind of increase of the risk sharing model. So if you could kind of elaborate on how margins look under this kind of with this new model and also kind of what are conditions today for working capital in Colombia and what are you currently running in terms of kind of base of working capital and so on. Thank you.

這就是第一個。其次，您在通話中提到了哥倫比亞的最新情況，即風險分擔模式的增強。因此，如果您可以詳細說明一下這種新模式下的利潤率如何，以及目前哥倫比亞的營運資金狀況如何，以及您目前的營運資金基礎如何等等。謝謝。

You say you want to start with that one.

你說你想從那個開始。

Capital, the last part of the question, of course. So thank you so much for the question. So from a working capital perspective and as we kind of mentioned in the earnings release. Our view specifically in Colombia is obviously to prioritize cash overgrowth in the short term, and as we've seen from our cash conversion cycle, we've maintained it basically flat in 2024 versus what we had in 2023. Any movements in accounts receivable days have been funded through accounts payable and inventory days.

資本，當然是問題的最後一部分。非常感謝您的提問。因此，從營運資本的角度來看，正如我們在收益報告中所提到的。我們對哥倫比亞的看法顯然是優先考慮短期內的現金過度成長，正如我們從現金轉換週期中看到的那樣，與 2023 年相比，2024 年的現金成長基本上持平。應收帳款天數的任何變更均由應付帳款和庫存天數提供資金。

We continue to work obviously dynamically in the case of Colombia and obviously regionally as far as working capital management and specifically, and I don't want to also give the answer to the second part of the question. I'll let Suso take the risk sharing models, but I would comment that they have a better cash conversion cycle. Given that they are paid up front and so obviously the fact that we're migrating part of our mix to a larger portion of risk sharing models in Colombia is also beneficial for the cash conversion cycle.

在哥倫比亞的案例中，我們顯然會繼續在區域範圍內進行動態工作，尤其是在營運資金管理方面，但具體來說，我不想回答問題的第二部分。我會讓蘇索採用風險分擔模式，但我想說他們有更好的現金轉換週期。鑑於他們是預先付款的，因此顯然我們將部分組合轉移到哥倫比亞更大比例的風險分擔模式這一事實也有利於現金轉換週期。

Great. Thank you, as you said, two parts of the question to be answered on the risk sharing models. So the risk sharing models for us, we manage within the Axis group, which is the insurance and another plans group, and we see it it's a B2B product that we offer insurance companies. We're offering, we're starting to offer them also in Mexico, and it's some relationship by which we take risk in volume.

偉大的。謝謝，正如您所說，這個問題有兩部分需要回答，即風險分擔模型。因此，對我們來說，風險分擔模式是在 Axis 集團（保險和另一個計劃集團）內進行管理的，我們認為這是我們向保險公司提供的 B2B 產品。我們正在提供，我們也開始在墨西哥提供這些服務，這是我們承擔數量風險的某種關係。

No, or in frequency of certain types of events, for a more complete treatment that includes, it might be, it's not only for example with the surgery, it's everything from the diagnosis all the way to including it could be services at home. No, we do it for cardiology, for oncology, we do it for many practices and we take a risk, especially because we cap normally a price. We say if you give us this amount of volume of these procedures, all of them included, then we'll take care of your patient integrated into our facilities at this price. So we take a risk on the price or on the volume.

不，或在某些類型事件的頻率上，對於更完整的治療，可能包括，它不僅包括手術，還包括從診斷一直到包括在家的服務的一切。不，我們為心臟病學、腫瘤學等許多實踐做這件事，而且我們承擔風險，特別是因為我們通常會限制價格。我們說，如果您給我們這麼多的手術量，包括所有手術，那麼我們將以這個價格在我們的設施中照顧您的病人。因此，我們在價格或數量上承擔風險。

They're very much aligned with what we do, in oncology and other practices. They're very much aligned in what we want to do because they scale. They're standardized the procedures, know that scale very well with high predictability in terms of the revenues we get from them, the cost that we have we have of them, and of course the patient journey and the medical outcome. So these normally have, slightly decreased margins to fee for services.

它們與我們在腫瘤學和其他實踐中所做的工作非常一致。他們與我們想做的事情非常一致，因為他們具有可擴展性。他們對流程進行了標準化，非常了解我們從中獲得的收入、我們承擔的成本，當然還有患者的旅程和醫療結果，並且具有高度的可預測性。因此，這些服務費的利潤通常會略微下降。

But as we scale, I think that is diminished a bit, and they're profitable for us, they're attractive for us because it's they're scale models, no, but maybe slightly lower margins than fee for service now on (inaudible).

但隨著我們規模的擴大，我認為這種情況會有所減少，而且它們對我們來說是有利可圖的，它們對我們來說很有吸引力，因為它們是規模模型，不，但現在的利潤率可能比服務費略低（聽不清楚）。

So we have a, as you might recall, we have a strategy of always repricing our policies depending on medical inflation and any new therapies that are included. No. And we do it constantly and throughout the year, no, I think I'm uncertain as to the exact number of the 2025 price increases, no, but I think today the MLR is stable.

因此，您可能還記得，我們​​有一個策略，即根據醫療通膨和任何包含的新療法不斷重新定價我們的政策。不。我們全年都在不斷地這樣做，不，我認為我不確定 2025 年價格上漲的具體數字，不，但我認為今天的 MLR 是穩定的。

Remember it's very much related to MLR. The MLR is stable. It's 52%, 53%, and I think right now I see the company including what we have included in the past with the price increases related to medical inflation and nothing more specific to that. More importantly, we are rolling out new. A complimentary insurance plans and other practices that we'll talk about in the future. No, that will complement the oncology healthcare plan.

請記住，它與 MLR 密切相關。MLR 穩定。是 52%、53%，我認為現在我看到公司包括了我們過去所包含的與醫療通膨相關的價格上漲，沒有更具體的內容。更重要的是，我們正在推出新產品。我們將來會討論免費保險計劃和其他做法。不，這將補充腫瘤醫療保健計劃。

Okay. Great thank you so much.

好的。太好了，非常感謝。

Alejandro Zamacona, HSBC.

匯豐銀行的亞歷杭德羅‧札馬科納 (Alejandro Zamacona)。

Thank you. Good morning, Suso. A couple of questions from our side. First one is on the oncology agreement with Oogia. And so how much volume can you bring given that they hold 30% of the market share and what percentage are you assuming this transfer to and then in addition related to this agreement, what are--

謝謝。早上好，蘇索。我們有幾個問題。第一個是與 Oogia 達成的腫瘤學協議。那麼，考慮到他們佔了 30% 的市場份額，你能帶來多少銷售？你假設這個轉移的百分比是多少？此外，與該協議相關的還有什麼？

I think we lost him.

我想我們失去他了。

Joseph Giordano, J.P. Morgan.

約瑟夫·喬達諾，J.P. 摩根。

Oh hi, good morning everyone. Hi, Suso and Lorenzo, thanks for taking my question. Actually, like, take a different route and discuss a little bit expansion of the network, right? So we do have like some plans to expand network of services in Peru. So if you could update us on that front. That would be great. And then second, concerning [uncomaxis], so now I have like, so very affluent, oncologist, in the northern part of Mexico, the like research center being set up in Mexico.

哦，嗨，大家早安。嗨，Suso 和 Lorenzo，謝謝你們回答我的問題。實際上，就像採取不同的路線並討論網路的一點擴展，對嗎？所以我們確實有一些計劃來擴大秘魯的服務網絡。所以如果您能向我們通報一下這方面的情況的話。那太好了。第二，關於 [uncomaxis]，現在我在墨西哥北部有一位非常富有的腫瘤學家，在墨西哥建立了類似的研究中心。

So my question to you goes like in. How are you seeing accrediting new service providers to roll out to Mexico, particularly when it comes to Mexico City and Guadalajara, which are two major centers that do not have like a direct presence.

所以我的問題是這樣的。您如何看待新服務提供者在墨西哥開展業務的認證，特別是對墨西哥城和瓜達拉哈拉這兩個沒有直接業務的主要城市而言。

Thank you.

謝謝。

Great, thank you, Joe. Nice to hear you. So, I say, can you remind me the first part of the question? I remember Mexico, but I jotted something down and I can't--

太好了，謝謝你，喬。很高興聽到你的聲音。那麼，我說，你能提醒我問題的第一部分嗎？我記得墨西哥，但我記下了一些內容，但我不能——

It was expansion.

這是擴張。

Oh yeah, Peru, yeah. So, I don't like commenting very much about, deployments of capital in the future and I haven't really, solid and well grounded. I do see that we're reaching capacity to, we run our hospitals and once they reach 80%, 85%, we start talking about an expansion and once [Onco Saud] penetrates into the hospitals that are general healthcare hospitals and they become integrated. That's another trigger. So we see that happening at the end of the year. So most probably you'll see as I'm starting to assess and an expansion. Most probably the Clinica Delgado, which has all the engineering and most of the stuff already done, next year.

哦是的，秘魯，是的。所以，我不太喜歡對未來的資本部署發表太多評論，而且我也沒有真正紮實和有根據的部署。我確實看到我們正在達到容量上限，我們經營著我們的醫院，一旦達到 80%、85%，我們就開始談論擴建，一旦 [Onco Saud] 滲透到綜合醫療保健醫院，它們就會整合在一起。這是另一個觸發因素。因此，我們預計這一情況將在年底發生。因此，您很可能會看到我開始評估和擴展。最有可能的是 Clinica Delgado，其所有工程和大部分工作都已於明年完成。

Next year, most probably to inaugurate maybe 2027. It's a little bit, it's a I take it as a directional comment, not a, not a calendar event. I know Jesus is looking at me like her eyes, I can see them. But anyway, yeah, so I see ourselves, yes, rolling out a little more capacity, most probably in at the end of 2026 and 2027.

明年，最有可能是 2027 年就職。這有點，我把它當作一個方向性的評論，而不是一個日曆事件。我知道耶穌正像她的眼睛一樣看著我，我能看見它們。但無論如何，是的，所以我認為我們自己將會推出更多的產能，最有可能是在 2026 年底和 2027 年。

On Mexico. So yeah, it's critical for us given the conversations we're having with many of the payers as you can imagine they're saying, yeah, great in Monterrey, what are you doing in the other cities? And we have been closing agreements. In Guadalajara, in Mexico city to deliver services within our plans and also for third parties within our system, so we're agreeing with doctors on the protocols, on the services, on the own way of doing things in agreements that will normally, if we're successful, end up in a much more intimate relations that may be in the structural integration of those facilities.

關於墨西哥。所以，是的，這對我們來說至關重要，因為我們正在與許多付款人進行對話，你可以想像他們會說，是的，蒙特雷很棒，你在其他城市做什麼？我們一直在達成協議。在瓜達拉哈拉和墨西哥城，我們按照計劃提供服務，也為系統內的第三方提供服務，因此，我們與醫生就協議、服務和自己的做事方式達成一致，如果我們成功的話，這些協議通常會建立更加密切的關係，可能體現在這些設施的結構整合中。

So we can do that well in in for surgery and for chemotherapy stations and as well for radiation services and we're way ahead of that, making sure that [Uncom] Mexico has a national footprint. We're doing the same thing also in Tijuana. Also in conversations to to deliver the services that we need in that city as well. So yes, we are well ahead of that and I think we'll be able to show some of that later in the year.

因此，我們可以在手術、化療站以及放射服務方面做得很好，而且我們在這方面遙遙領先，確保墨西哥的 [Uncom] 業務在全國範圍內具有影響力。我們在蒂華納也做同樣的事情。我們也在討論如何在該城市提供我們所需的服務。是的，我們已經領先很多了，我認為我們將能夠在今年晚些時候展示一些成果。

Thank you, Suso.

謝謝你，蘇索。

Alejandro Zamacona, HSBC.

匯豐銀行的亞歷杭德羅‧札馬科納 (Alejandro Zamacona)。

Apologies, that was a great time to get disconnected. My question was regarding, the oncology agreement with Optional [Collojia]. So how much, of the 30% of the market share that they currently hold, you are assuming that it's going to be transferred to AUA. And also, what are the margin expectations, for the first, one or two years as volume is ramped up.

抱歉，剛才斷線了。我的問題是關於與 Optional 的腫瘤學協議[科洛賈]。那麼，您認為他們目前佔有的 30% 的市場份額中有多少會轉移給 AUA。此外，隨著銷售量的增加，前一兩年的利潤預期是多少？

So I don't want to, forecast some or reveal, margin, of these businesses, but I would say, a couple of things, Alejandro in. So our agreement with them is about the 30% and how it gets channelled into Auna is a question of time, I think it can, with the plans that we have in place, it's not only about the 30%, capacity market share that they have in in oncology in Monterrey. Actually, for us, the spillover effect of a doctor leaving the imaging and the pharma and the labs and the surgery. Remember, these are chemotherapists, which is a critical gatekeeper in oncology is a chemotherapist.

所以我不想預測或透露這些業務的利潤，但我想說幾件事，亞歷杭德羅。因此，我們與他們的協議是關於 30% 的，至於如何將其引入 Auna，這是一個時間問題，我認為可以，按照我們現有的計劃，這不僅僅是關於他們在蒙特雷腫瘤學領域擁有的 30% 的容量市場份額。實際上，對我們來說，醫生離開影像、製藥、實驗室和手術會產生溢出效應。請記住，這些都是化療治療師，他們是腫瘤學中的關鍵守門人。

He or she is normally the one that determines where the surgery is going to happen, where the labs are going to happen, where the imaging is going to happen, and even where the radiation is going to happen. No, this is like the primary care in many other diseases. The chemotherapist is the one deciding is the one deciding that, no.

他或她通常決定手術在哪裡進行、實驗室在哪裡進行、成像在哪裡進行，甚至放射在哪裡進行。不，這就像許多其他疾病的初級護理一樣。化療治療師才是決定者，不是嗎？

So for us it's not only about the volume that they currently have today they actually channel the surgeries and the other services I just listed out to others, so this is going to be very promising and in line from what we expected to occur. So I would not be surprised that in due time in a couple of years, we would have 30% of the Of the oncology market in Monterrey.

因此，對我們來說，這不僅關乎他們目前的業務量，他們實際上還將手術和我剛才列出的其他服務提供給其他人，所以這將是非常有希望的，並且符合我們的預期。因此，我不會感到驚訝，幾年後我們將佔據蒙特雷腫瘤學市場 30% 的份額。

And my second question regarding, Colombia in your press release, you mentioned that you have been phasing out selected services to Nueva IPS in and Tokyo.

我的第二個問題是關於哥倫比亞的，在您的新聞稿中，您提到您已經逐步取消了對 Nueva IPS 和東京的部分服務。

Can you provide more detail on the facing of these services? I mean, and specifically what would be the next, or the new mix after the competition of this facing strategy?

您能否提供更多關於這些服務的細節？我的意思是，具體來說，在這種面向策略的競爭之後，下一步或新的組合會是什麼？

So, I think it would be difficult to see on a month to month or quarter to quarter what would be the stable state of the situation in Colombia. I think that the stresses in Colombia's healthcare systems will produce a [Nuevaepees] at the right time.

因此，我認為很難透過月度或季度來判斷哥倫比亞的局勢是否穩定。我認為哥倫比亞醫療保健系統的壓力將在適當的時候產生[Nuevaepees]。

There will be a payer that has the capacity and not the political agenda, so I think that at the end of the year it wouldn't surprise me that, our business with is reasonable. We've been disciplined with them and they have been delivering on the commitments with us now from here to the end of the year, no, we're playing rough.

將會有一個有能力而不是政治議程的付款人，所以我認為到今年年底，我們的業務是合理的，這並不會讓我感到驚訝。我們對他們一直很嚴謹，從現在到年底，他們也一直在履行對我們的承諾，不，我們太粗暴了。

And limiting services until they I don't want to use the use the wrong words but maybe until they get their full act together, not today because of the intervention and the politics down there, the act, they don't have it together, but they need to get it together. I see in the last few weeks, a dialogue that is the best we've had in the last 6 to 12 months with them.

並限制服務，直到他們，我不想用錯誤的詞語，但也許直到他們完全採取行動，而不是今天，因為幹預和那裡的政治，該行為，他們沒有把它放在一起，但他們需要把它放在一起。我發現，過去幾週我們與他們進行的對話是過去 6 到 12 個月以來最好的一次。

No, and of course it's not only because we're being tough with them, it's because patients are being really tough with them. So I see it's 7 o'clock.

不，當然這不僅是因為我們對他們很嚴厲，還因為患者對他們真的很嚴厲。我看到現在是 7 點。

So yes, so I see an opportunity there, but it's difficult to see what's going to happen quarter by quarter. But I think at the end of the year it wouldn't surprise me. They are very relevant players are very relevant in our geographies. I think that. They'll come back in a very organized and ordered way and we'll have a strong relations in the future with them.

是的，我看到了機會，但很難預測每季會發生什麼。但我認為到年底這不會讓我感到驚訝。他們是我們地理位置上非常相關的參與者。我認為如此。他們會以非常有組織、有序的方式回來，我們將來會與他們建立牢固的關係。

You said you want to add something to that?

你說你想添加一些東西嗎？

I think, very much in line with what you commented Suso, very much focused on this year, obviously on cash flow, which leads us to focus the revenue mix on the risk sharing models and also diversify payer risk.

我認為，這與蘇索的評論非常一致，今年我們非常關注現金流，這讓我們將收入組合的重點放在風險分擔模式上，同時也分散了付款人風險。

And there are no more questions from the phone line, so I will now turn the call over to Anna Maria Mora from Auna, who will proceed with questions from the webcast platform.

電話線上沒有其他問題了，所以我現在將電話轉給 Auna 的 Anna Maria Mora，她將繼續回答網路直播平台上的問題。

Thank you, [Freer]. The first question comes from Gallo Muscardini. Can you please comment on the different dynamics in Peru, which led to occupancy rates to fall year over year.

謝謝你，[弗里爾]。第一個問題來自 Gallo Muscardini。您能否評論一下秘魯導致入住率逐年下降的不同動態？

Can you please comment on adjusted EBITDA growth expectations for 2025 that the internal goal to achieve 20% adjusted EBITDA growth per year also applies to 2025.

您能否評論一下 2025 年調整後 EBITDA 成長預期，即實現每年 20% 調整後 EBITDA 成長的內部目標也適用於 2025 年。

Well, I think that, I think it's important again to note, you can correct me, we're having difficulty. Setting a guidance of 20% this year. It's very important that we, I want to highlight that we work on the 20% internally, and that's what we represent in the past. The uncertainty in Colombia has made us not want to give the guidance of the 20% internally we do work on.

嗯，我認為，我認為再次注意這一點很重要，你可以糾正我，我們遇到了困難。今年的指導價為 20%。非常重要的一點是，我想強調的是，我們在內部致力於實現 20%，這就是我們過去所代表的。哥倫比亞的不確定性使得我們不想給出我們內部正在進行的 20% 的指導。

I think we might be able to come back on that point in the next quarters right now until we make sure of the certainty of the Colombia situation and what's going to occur there we're uncomfortable given the 20 giving that guidance. No, I think our goal is at 20%. I don't know if I want to differentiate that in that way. No, Jesus, do you want to compliment so that you know our investors are clear on what we're expecting in 2025 and what we're saying we're going to do in 2025?

我認為我們可能能夠在接下來的幾個季度重新討論這一點，直到我們確定哥倫比亞局勢的確定性以及那裡將會發生什麼，我們對 20 給出的指導感到不安。不，我認為我們的目標是 20%。我不知道是否想以那種方式來區分它。不，耶穌，你想稱讚一下，以便你知道我們的投資者清楚我們對 2025 年的期望以及我們所說的 2025 年要做的事情嗎？

Yeah, maybe Suso to complement that point. I think it's important to note that in 2024 we met our annual guidance with 20% FXN growth despite the headwinds that we may have faced and particularly in the case of Colombia.

是的，也許蘇索可以補充這一點。我認為值得注意的是，儘管我們可能面臨阻力，特別是在哥倫比亞，但我們在 2024 年仍實現了 20% FXN 成長的年度預期。

Therefore, kind of reiterating Suso's point as he's already commented, given the continuous uncertainty with payers in Colombia, it is difficult to provide the same certainty of guidance for 2025. However, our internal goal continues to be to grow at 20%. That is our North Star, even though at this point in time it is a little bit more difficult for us to phrase it as guidance.

因此，重申蘇索的觀點，正如他已經評論的那樣，鑑於哥倫比亞付款人的持續不確定性，很難為 2025 年提供同樣確定的指導。然而，我們的內部目標仍然是成長 20%。這就是我們的北極星，儘管目前我們很難將其作為指導。

To tackle the second part of Gallo's question, thank you for the question. Gallo on occupancy levels in the case of Peru, specifically in Peru, we had a slight drop in occupancy rates in the fourth quarter as we continue to optimize pricing and increase high complexity.

為了回答加洛問題的第二部分，感謝您的提問。加洛談到秘魯的入住率時表示，特別是在秘魯，由於我們繼續優化定價並增加高複雜性，第四季度的入住率略有下降。

Thank you, Gisele. The next question comes from (inaudible). Hi everyone, I have two questions. Could you provide more details on how these risk sharing models have contributed to the revenue and IIA growth in Colombia and what expectations do you have for the impact of this initiatives in the coming quarters?

謝謝你，吉賽兒。下一個問題來自（聽不清楚）。大家好，我有兩個問題。您能否提供更多細節，說明這些風險分擔模式如何促進哥倫比亞的營收和國際投資協定的成長，以及您對這些措施在未來幾季的影響有何預期？

And the second question is, could you provide more details on other income in Colombia and the increasing corporate expenses at [Uncoalud] and healthcare services during 2024.

第二個問題是，您能否提供更多關於哥倫比亞其他收入以及 2024 年 [Uncoalud] 和醫療保健服務不斷增加的企業費用的詳細資訊。

So on the first question for us, and the risk sharing model is critical to our strategy and our nature. It produces what we always are looking. For is predictability on the patient journey, the medical outcome, and of course the financial results. So for us it's critical.

因此，對我們來說，第一個問題是風險分擔模式對於我們的策略和性質至關重要。它產生了我們一直在尋找的東西。對於患者旅程、醫療結果以及財務結果的可預測性。所以對我們來說這至關重要。

Healthcare is very komplett And very anecdotal, and one can be lost in the, in the variability by conquering that variability, and producing them certainty and predictability, the opportunity is much richer and much bigger. So we see ourselves scaling that.

醫療保健非常複雜，而且非常具有軼事性，人們可能會迷失在多變性中，透過征服這種多變性，並為其產生確定性和可預測性，機會會更加豐富，更大。因此，我們看到自己正在擴大這一規模。

I don't remember the exact numbers in Colombia in particular, we're going something from. Low 10s, I think mid-10s. To maybe high 20s in terms of the revenue risk represented by risk sharing models. What's very important, I want to highlight, this is a competitive advantage. Few players can deliver that.

我不記得哥倫比亞的具體數字，我們只能從中得出一些數字。出手 10 倍，我認為是 10 倍中。就風險分擔模型所代表的收入風險而言，可能高達 20% 以上。我想強調的是，非常重要的一點是，這是一種競爭優勢。很少有球員能夠做到這一點。

It requires a certain unique way of operating. It's a little of an insurance mentality and a health healthcare service provider merged together. Because there is risk and there is a healthcare, the healthcare service component, of course, no. So, I think this is something that makes Auna very attractive, and produces what we mostly seek, which is volume. Then we are a growth player in volume, and this is a key component that produces the growth in volume.

它需要某種獨特的操作方式。這有點像保險理念和醫療保健服務提供者的融合。因為有風險，而且有醫療保健，當然沒有醫療保健服務部分。所以，我認為這是 Auna 非常有吸引力的原因，並且能夠滿足我們最需要的品質，即產量。那麼，我們就是一個數量成長的參與者，這是產生數量成長的關鍵因素。

Gisele, you said you want to add on that?

吉賽爾，你說你想補充這一點？

No, I think so expressed it well and maybe to tackle the second part of the question, vis a vis other income and corporate expenses. Specifically in the case of other income, which as we know, is a line that reflects non-operating impacts as far as income and expenses.

不，我認為這樣表達很好，也許可以解決問題的第二部分，即其他收入和公司費用。具體來說，就其他收入而言，正如我們所知，這是一條反映收入和支出的非經營性影響的線。

In the case of Colombia in the fourth quarter, the most material impact there would have probably been the reversal of a tax provision which would no longer come due.

就哥倫比亞第四季的情況而言，最重大的影響可能是撤銷不再到期的稅收規定。

And in the case of corporate expenses, nothing too material to report, just basically the same progression that we've discussed in previous quarters as far as the regional and integrated capabilities that we're building, which are basically around also bearing material fruit as far as synergies and efficiencies across the board both in the medical practice as well as in cost and SG&A from being able to operate in a regional manner and have all of our procurement and negotiations and strategies reflect that scale.

就公司費用而言，沒有什麼重大事項需要報告，基本上與我們在前幾個季度討論過的有關區域和綜合能力建設的進展相同，這些進展基本上也產生了實質性成果，因為能夠以區域方式運營，並且我們所有的採購、談判和戰略都反映了這一規模，無論是在醫療實踐方面，還是在成本和銷售、一般及行政費用方面，都產生了協同效應和效率。

I don't know if there's more questions from the chat.

我不知道聊天中是否還有其他問題。

Yeah. The last question that we have in [Nachat] comes from [Omar Aliyan]. Sorry, what is your expectation for that reduction in 2025?

是的。我們在[Nachat]中提出的最後一個問題來自[奧馬爾·阿里揚]。抱歉，您預計 2025 年的減幅是多少？

Great, so thank you. I can tackle that question, and as I think as Suso already noted, we're not giving any specific, leverage or balance sheet guidance, for the year. However, we continue to be very focused on deleveraging, and as we've seen in 2024, our proven capacity to grow EBITDA and improve liquidity has taken us to 3.6 times net debt to EBITDA at the end of 2024, and we continue to be focused on our medium term target to take that leverage level to 3 times net debt.

太好了，謝謝你。我可以回答這個問題，而且我認為正如蘇索已經指出的那樣，我們今年不會給出任何具體的槓桿或資產負債表指導。然而，我們繼續高度重視去槓桿，正如我們在 2024 年所看到的那樣，我們已證明有能力增加 EBITDA 並改善流動性，到 2024 年底，我們的淨債務與 EBITDA 之比已達到 3.6 倍，我們將繼續專注於我們的中期目標，將槓桿率提高到淨債務的 3 倍。

Thank you, Gisele. At this time I'm not showing any more questions. I would like to turn the call back over to Suso, who has a few closing remarks.

謝謝你，吉賽兒。目前我不再提出任何問題。我想把電話轉回蘇索，他還有一些最後發言。

Thank you. Thank you very much, Annie. I think, I don't know if you feel comfortable, but I think we are managing the company with a little bit over a billion dollars of debt ceiling. And we have no plans to increase the absolute amount of debt, so I think that should give investors a clear view on where we're going in the future. No, I just want to again thank everybody for their support, the analysts and the investors, of course, and I want to repeat, we're just, we're not just another provider of healthcare.

謝謝。非常感謝，安妮。我想，我不知道您是否感到舒服，但我認為我們管理公司的債務上限略高於 10 億美元。而且我們沒有增加債務絕對額度的計劃，所以我認為這應該能讓投資者清楚地了解我們未來的發展方向。不，我只是想再次感謝大家的支持，當然還有分析師和投資者，我想重申一下，我們不僅僅是另一家醫療保健提供者。

Our motto is really unique and very transformative. It does take a bit more time to ground and expand in a country like Mexico, for example, but we're getting there, now, in the medium and long term view of this, we have not changed the position. No, in the short term, we might be fine tuning the model and how we ground it in Mexico in particular where we're just new, no, but, things are clear that they're coming the way we planned them and we see the horizon is very promising.

我們的座右銘確實非常獨特且具有變革性。例如，在墨西哥這樣的國家紮根和擴張確實需要更多時間，但我們現在正在實現這一目標，從中長期來看，我們不會改變立場。不，在短期內，我們可能會對模型進行微調，以及我們如何將其應用於墨西哥，特別是在我們剛剛進入的地方，不，但是，事情很明顯正在按照我們計劃的方式進行，我們看到前景非常光明。

Thank you, everybody, for the support again and thank you operator for the support in the meeting as well. Thank you, Gisele, Lorenzo, Annie.

再次感謝大家的支持，也感謝操作員在會議中的支持。謝謝你，吉賽兒、洛倫佐、安妮。

Thank you. This concludes today's conference call. You may now disconnect.

謝謝。今天的電話會議到此結束。您現在可以斷開連線。